Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-535 Poznan, Poland.
Gynecol Endocrinol. 2010 Sep;26(9):652-7. doi: 10.3109/09513590.2010.486452.
One of the most important hormonal factors responsible for bone health is estradiol. Genetic factors, adequacy of hormonal functioning, nutrition and physical activity may be the markers of bone status and development in young women. During adolescence, women reach peak bone acquisition and develop a skeletal mass. This process is largely regulated by endocrine factors mainly such as adequate levels of gonadal, adrenal and pituitary hormones. The crucial role played by estradiol and its impact on bones are very multiple. Estradiol induces growth factors' activation, receptor activator of nuclear factor kappa B ligand (RANKL) production inhibition and is mainly referred to antiresorptive activity. Clinical situations leading to hypoestrogenism has been linked to decreased bone mineral density leading to osteopenia and osteoporosis. This status both in fertile and perimenopausal women can increase the risk of pathological fractures. Such conditions as hypothalamic-pituitary insufficiency (functional hypothalamic amenorrhea, anorexia nervosa, Kallmann syndrome, hyperprolactinemia), ovarian failure (gonadal dysgenesis, premature ovarian failure) and iatrogenic treatment (surgery, chemotherapy, radiotherapy) can cause hypoestrogenism. The treatment of osteopenia and osteoporosis caused by hypoestrogenism is very essential and multidirectional. The crucial role of the therapy is the achievement of proper serum estradiol concentration and eliminate the causes of hypoestrogenism.
负责骨骼健康的最重要的激素因素之一是雌二醇。遗传因素、激素功能的充分性、营养和身体活动可能是年轻女性骨骼状况和发育的标志物。在青春期，女性达到骨量峰值并发展出骨骼质量。这个过程主要受内分泌因素调节，主要是性腺、肾上腺和垂体激素的水平。雌二醇起着至关重要的作用，对骨骼有多种影响。雌二醇诱导生长因子的激活，抑制核因子κB 受体激活剂配体（RANKL）的产生，主要表现为抗吸收活性。导致雌激素水平降低的临床情况与骨矿物质密度降低导致的骨质疏松症和骨质疏松症有关。这种在生育期和围绝经期妇女中都存在的情况会增加病理性骨折的风险。下丘脑-垂体功能不全（功能性下丘脑闭经、神经性厌食症、卡尔曼综合征、高催乳素血症）、卵巢衰竭（性腺发育不全、卵巢早衰）和医源性治疗（手术、化疗、放疗）等情况会导致雌激素水平降低。治疗因雌激素水平降低引起的骨质疏松症非常重要且具有多方向性。治疗的关键是达到适当的血清雌二醇浓度并消除雌激素水平降低的原因。
